HESI LPN
Adult Health Exam 1
1. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?
- A. Increases joint lubrication
- B. Reduces inflammation by suppressing the immune system
- C. Enhances bone density
- D. Stimulates cartilage regeneration
Correct answer: B
Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.
2. During a health screening, a client's blood pressure reads 160/100 mm Hg. What should the nurse recommend?
- A. Schedule a follow-up appointment
- B. Start making immediate dietary changes
- C. Begin an exercise program
- D. All of the above
Correct answer: A
Rationale: A follow-up with a healthcare provider is necessary to assess and manage the newly identified hypertension. While dietary changes and exercise are important for managing high blood pressure, immediate lifestyle modifications without further evaluation by a healthcare provider may not be safe or effective. Option A is the most appropriate initial step to ensure proper assessment and management of the client's blood pressure. Therefore, choices B and C are incorrect in this scenario. Option D is also incorrect because not all options should be implemented without proper medical guidance.
3. The nurse is caring for a client with a chest tube after thoracic surgery. What is the most important assessment related to the chest tube?
- A. Ensure continuous bubbling in the water seal chamber
- B. Measure the amount of drainage every shift
- C. Keep the drainage system at the level of the chest
- D. Assess for subcutaneous emphysema around the insertion site
Correct answer: D
Rationale: The most important assessment related to a chest tube after thoracic surgery is to assess for subcutaneous emphysema around the insertion site. Subcutaneous emphysema can indicate air leakage from the pleural space, which can lead to serious complications such as a pneumothorax. Ensuring continuous bubbling in the water seal chamber is not the most critical assessment as it is a normal finding in a chest drainage system. While measuring the amount of drainage is important to monitor the client's condition, it is not as crucial as assessing for subcutaneous emphysema. Keeping the drainage system at the level of the chest helps maintain proper function but is not the most critical assessment in this scenario.
4. The client is being educated by the nurse about the side effects of prednisone. Which side effect should the client be instructed to report immediately?
- A. Weight gain.
- B. Increased appetite.
- C. Hyperglycemia.
- D. Fever or sore throat.
Correct answer: D
Rationale: The correct answer is D: Fever or sore throat. These symptoms should be reported immediately as they could indicate an infection, which can be serious in clients taking prednisone due to its immunosuppressive effects. Choices A and B are common side effects of prednisone but are not typically considered urgent. Choice C, hyperglycemia, is a known side effect of prednisone but is not an immediate concern compared to the potential of an infection signaled by fever or sore throat.
5. A client is being treated for heart failure. What should the nurse monitor to evaluate treatment effectiveness?
- A. Daily weight
- B. Electrolyte levels
- C. Urine output
- D. All of the above
Correct answer: D
Rationale: Monitoring daily weight, electrolyte levels, and urine output is crucial in evaluating treatment effectiveness for heart failure. Daily weight monitoring helps assess fluid retention or loss, changes in electrolyte levels can indicate imbalances affecting heart function, and urine output monitoring provides insights into kidney function and fluid balance. Therefore, all options are essential components in assessing the patient's fluid status and response to treatment, making 'All of the above' the correct answer. Choices A, B, and C are incorrect individually as they only represent partial aspects of monitoring heart failure treatment effectiveness.
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